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Zakażenie i martwica powikłaniem po ukąszeniu owada

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Użądlenia i ukąszenia owadów mogą powodować zmiany skórne takie jak rumień, obrzęk i świąd, może także dojść do wystąpienia groźnych powikłań takich jak stany zapalne, infekcje bakteryjne, a w niektórych przypadkach do wstrząsu anafilaktycznego lub martwicy.

W sezonie letnim występuje ryzyko ukąszeń i ugryzień przez owady. Może to doprowadzić do groźnych powikłań, dlatego istotne jest obserwowanie występujących na skórze zmian i odpowiednie reagowanie. Za użądlenia w Polsce odpowiadają najczęściej osy, szerszenie oraz pszczoły, a także w niewielkim stopniu trzmiele ziemne.

Objawy użądleń owadów

Reakcja na użądlenie owada może przebiegać łagodnie lub w sposób nasilony. Najczęściej w miejscu użądlenia powstaje rumień i obrzęk, pojawia się miejscowy stan zapalny, a w jego konsekwencji ból, pieczenie lub uczucie rozpierania. Są to objawy krótkotrwałe. Miejscowe dolegliwości sprawiają, że użądleni często drapią i podrażniają obszar występujących objawów, co skutkuje nasileniem stanu zapalnego, a w niektórych przypadkach doprowadza do infekcji bakteryjnej.

Reakcja alergiczna może wystąpić natychmiast po użądleniu lub z opóźnieniem do około 24 godzin. Do objawów miejscowych należą pokrzywka, swędzenie oraz obrzęk w miejscu użądlenia, ale mogą również wystąpić objawy ogólne takie jak trudności z oddychaniem, zawroty głowy lub gwałtowny spadek ciśnienia krwi, a także nudności, drętwienie kończyn, utrata przytomności, a nawet zatrzymanie akcji serca.

W przypadku pacjentów, u których wystąpiła ogólna reakcja alergiczna po użądleniu, istnieje 60 proc. szans, że przy ponownym użądleniu pojawi się podobna lub silniejsza reakcja.

Leczenie zmian po użądleniach

Zwykle objawy po użądleniu ustępują samoczynnie. W przypadku występowania nasilonego obrzęku (średnica odczynu powyżej 10 cm) przez dłuższy czas konieczna jest konsultacja z lekarzem. Takie objawy mogą świadczyć o uczuleniu na jad błonkówek lub zakażeniu miejsca użądlenia. Konieczne może być leczenie środkami przeciwalergicznymi lub antybiotykami, a także dalsza konsultacja z alergologiem. Szczególną ostrożność należy zachować w przypadku dzieci, ponieważ kolejne użądlenie zwiększa ryzyko wystąpienia silnej reakcji. Stopień ryzyka można sprawdzić poprzez wykonanie punktowego testu skórnego z jadem owada. Silny odczyn i wysoki poziom przeciwciał klasy IgE przeciw jadowi wskazują na wysoki stopień zagrożenia.

Ukąszenia owadów

W okresie letnim w Polsce szczególnie nasila się występowanie owadów takich jak komary, kleszcze, pchły, pluskwy. Ich ukąszenia najczęściej wywołują łagodną reakcję, jednak w niektórych przypadkach może dojść do poważnych powikłań.

Objawy skórne po ukąszeniach owadów

Kiedy owad kąsa, zwykle wstrzykuje żywicielowi niewielkie ilości toksyn, w tym antykoagulantów, co może spowodować bezpośrednią reakcję organizmu lub uczulenie, które dopiero przy kolejnym ukąszeniu wywoła odpowiedź immunologiczną.

Po ukąszeniu owada występują takie objawy jak świąd w okolicach ukąszonego miejsca, pęcherz i rumień, a także zmiany pokrzywkowe z centralnie położonym pęcherzem, niekiedy grudki i mniejsze oraz większe pęcherzyki. Zmiany po ukąszeniach nie są rozległe i ulegają samoograniczeniu.

W zależności od gatunku owada różni się rozmieszczenie zmian. W przypadku ukąszeń po komarach występują asymetrycznie rozsiane po całym ciele zmiany, natomiast kleszcze pozostawiają pojedyncze zmiany. Ukąszenia pcheł występują zwykle w linii 3 lub 4 zmian położonych blisko siebie. Owady te atakują najczęściej dolne partie nóg, szczególnie podudzia i kostki, a także okolice bioder, barków. Pluskwy natomiast kąsają odsłonięte partie skóry i żerują nocą, pozostawiając drobne zmiany rozmieszczone blisko siebie, często w postaci jednej linii, ze względu na to, że owady te nakłuwają skórę wielokrotnie, nim znajdą odpowiednie naczynie krwionośne, z którego się pożywią.

Ugryzienia mrówek powodują świąd, ból oraz pieczenie skóry, a w niektórych przypadkach również drobne krostki, które mogą być oznaką alergii na jad tych owadów.

Powikłania po ukąszeniu owadów

W przypadku niektórych pacjentów dochodzi do uczulenia i w wyniku kolejnego ukąszenia mogą powstawać pęcherze, które przy ciężkim przebiegu ulegają owrzodzeniu oraz zakażeniu. W przypadku ciężkiego przebiegu reakcji mogą wystąpić objawy ogólne takie jak gorączka, powiększenie węzłów chłonnych, powiększenie śledziony lub limfocytoza we krwi obwodowej.

W miejscu ukąszenia może rozwinąć się odczyn podobny do tego, jaki występuje w przypadku pozostawienia ciała obcego w miejscu rany. W niektórych przypadkach zmiana ta utrzymuje się przez dłuższy czas, dlatego konieczne bywa chirurgiczne wycięcie.

W przypadku silnej reakcji na jad mrówek na skórze mogą wystąpić zmiany w postaci jałowych krostek, w szczególnych przypadkach nawet martwica skóry w miejscu ukąszenia, powstająca w wyniku przekształcenia się krostki.

Leczenie zmian po ukąszeniach

Większość zmian po ukąszeniach znika samoczynnie, jednak w niektórych przypadkach konieczna jest konsultacja ze specjalistą i wprowadzenie leczenia przy pomocy preparatów przeciwhistaminowych, a niekiedy również kortykosteroidów. W sytuacji nadkażenia bakteryjnego lekarz może zalecić zastosowanie antybiotykoterapii ogólnej lub działającej miejscowo.

Źródła: dermatologia praktyczna.pl

Przeczytaj także: Trądzik różowaty – metody leczenia i zabiegi kosmetologiczne

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